Colonization of a hand washing sink in a veterinary hospital by an Enterobacter hormaechei strain carrying multiple resistances to high importance antimicrobials
Open accessAbstract
Background: Hospital intensive care units (ICUs) are known reservoirs of multidrug resistant nosocomial bacteria. Targeted environmental monitoring of these organisms in health care facilities can strengthen infection control procedures. A routine surveillance of extended spectrum beta-lactamase (ESBL) producers in a large Australian veterinary teaching hospital detected the opportunistic pathogen Enterobacter hormaechei in a hand washing sink of the ICU. The organism persisted for several weeks, despite two disinfection attempts. Four isolates were characterized in this study. Methods: Brilliance-ESBL selective plates were inoculated from environmental swabs collected throughout the hospital. Presumptive identification was done by conventional biochemistry. Genomes of multidrug resistant Enterobacter were entirely sequenced with Illumina and Nanopore platforms. Phylogenetic markers, mobile genetic elements and antimicrobial resistance genes were identified in silico. Antibiograms of isolates and transconjugants were established with Sensititre microdilution plates. Results: The isolates possessed a chromosomal Tn7-associated silver/copper resistance locus and a large IncH12 conjugative plasmid encoding resistance against tellurium, arsenic, mercury and nine classes of antimicrobials. Clusters of antimicrobial resistance genes were associated with class 1 integrons and IS26, IS903 and ISCR transposable elements. The bla SHV-12, qnrB 2 and mcr -9.1 genes, respectively conferring resistance to cephalosporins, quinolones and colistin, were present in a locus flanked by two IS903 copies. ESBL production and enrofloxacin resistance were confirmed phenotypically. The isolates appeared susceptible to colistin, possibly reflecting the inducible nature of mcr -9.1. Conclusions: The persistence of this strain in the veterinary hospital represented a risk of further accumulation and dissemination of antimicrobial resistance, prompting a thorough disinfection of the ICU. The organism was not recovered from subsequent environmental swabs, and nosocomial Enterobacter infections were not observed in the hospital during that period. This study shows that targeted routine environmental surveillance programs to track organisms with major resistance phenotypes, coupled with disinfection procedures and follow-up microbiological cultures are useful to control these risks in sensitive areas of large veterinary hospitals.
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The E. hormaechei finding warrants further investigation for food safety purposes.
“warranting further investigation for food safety purposes. 108-110”
From Unexplored microbial diversity from 2,500 food metagenomes and links with the human microbiome. (2024) · cites this paper as [109]
The Results identify multidrug-resistant E. hormaechei in a veterinary hospital sink, and the Discussion raises concerns about antimicrobial resistance in that setting. Neither the supplied passages nor searches for food safety and food-chain implications found a passage connecting the finding to food safety or recommending investigation for that purpose. (LLM, conf=0.76)
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- Authors
- Kamathewatta, K., Bushell, R., Rafa, F., Browning, G., Billman-Jacobe, H., & Marenda, M.
- Affiliations
- The University of Melbourne (AU)
- Corresponding author
- Marenda, Marc
- Venue
- Antimicrobial Resistance & Infection Control
- Published
- 2020-10-21
- Volume
- 9
- Issue
- 1
- Pages
- 163-163
- ISSN
- 2047-2994 (ISSN-L)
- PMC
- PMC7580002
- OpenAlex
- W3093676746
- Cited by
- 27
- References
- 53
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 2 · 2023: 2 · 2022: 6 · 2021: 4
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Antimicrobial Resistance and Infection Control (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Physical Sciences › Environmental Science › Pollution › Pharmaceutical and Antibiotic Environmental Impacts
- Keywords
- Enterobacter hormaechei, multidrug resistance, extended-spectrum beta-lactamase, nosocomial infections, hand washing sink, veterinary hospital, intensive care unit, Tn7 transposon, class 1 integron, IS903, IS26, IscR, colistin resistance, blaSHV-12, enrofloxacin resistance, antimicrobial resistance genes, disinfection
- MeSH terms
- Whole Genome Sequencing, Animals, Australia, Enterobacter, Equipment Contamination, Hospitals, Animal, Hospitals, Teaching, Humans, Intensive Care Units, Microbial Sensitivity Tests, Phylogeny, Population Surveillance, Drug Resistance, Multiple, Bacterial, High-Throughput Nucleotide Sequencing
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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